First Name*

    Last Name*

    Email*

    Phone*

    Address 1*

    Address 2

    City*

    Zip code*

    Are you applying for LLT, Time Emporium, or both?* LLTTEBoth

    Are you a citizen of U.S. or authorized to work in the U.S.?* YesNo

    Have you worked under any other name? If so, please list.

    Have you ever been convicted of a felony or misdemeanor within the last 5 years? (This will not necessarily affect your application.)* YesNo

    Which of the following age categories do you fall under?
    15 & under1617-2021 & older

    Educational History

    High School Name

    Years Attended

    College Name

    Years Attended

    List any clubs, extracurricular activities, or other achievements relevant to this position.

    Employment Record

    Name your last three employers beginning with the most recent.

     

    Work Experience 1

    Company

    Address

    Job Title

    Duties

    Supervisor

    Pay rate

    Dates worked

    Reason for leaving

    Work Experience 2

    Company

    Address

    Job Title

    Duties

    Supervisor

    Pay rate

    Dates worked

    Reason for leaving

    Work Experience 3

    Company

    Address

    Job Title

    Duties

    Supervisor

    Pay rate

    Dates worked

    Reason for leaving

    In addition to your work history, are there any other skills, qualifications, or experiences that we should consider?

    What positions are you interested in?*

    Desired hours worked per week?

    What is your desired pay?

    Why would you like to work at LLT?*

    What skills do you feel you would bring to LLT if you were to be hired?*

    Is there anything else you would like us to know when reviewing your application?*